OBJECTIVE:To study the effects of trimetazidine on endothelin and nitric oxide(NO)in patients with unstable angina pectoris.METHODS:80 patients with unstable angina pectoris were randomly assigned to trimetazidine group(n=40)or conventional treatment group(n=40).The levels of endothelin(ET)and NO before treatment and at 4 weeks after treatment were determined.Meanwhile,another 40 healthy volunteers were assigned to normal control group and their fasting levels of ET and NO on resting were determined.RESULTS:In unstable angina pectoris patients,the NO level decreased significantly but plasma ET level increased significantly,showing significant difference as compared with the normal control group(P0.05).The level of NO increased markedly and the ET level decreased markedly in trimetazidine-treated group after treatment,showing significant differences as compared with before treatment(P

Objective To investigate the effect of statins and angiotensin receptor blocker (ARB) on paroxysmal atrial fibrillation in patients with chronic congestive heart failure. Methods All of 145 patients with chronic congestive heart failure and paroxysmal atrial fibrillation were randomly divided into four groups, Ⅰ group (treated with amiodarone ), Ⅱ group( treated with amiodarone and valsartan), Ⅲ group( treated with amiodarone and pravastatin)and Ⅳ group (treated with amiodarone,valsattan and pravastatin). After 2- year follow-up, observed the changes of left atrium diameter (LAD), C-reactive protein (CRP) and maintenance rate of sinus rhythm before and after treatment. Results After treatment, the data of LAD of the four groups were (44.1 ± 2.1 ), (41.7 ± 2.8), (44.4 ± 3.1 ), (40.1 ± 2.5) mm respectively. The LAD data of beth Ⅰ group and Ⅲ group were significantly higher than those of Ⅱ group and Ⅳ group (P < 0.05), but there was no significant difference either between Ⅰ group and Ⅲ group, or between Ⅱ group and Ⅳ group. The levels of CRP of the four groups were (4.56 ± 0.24), (4.47 ± 0.45 ), (2.87 ± 0.53 ), (2.54 ± 0.42) mg/Lrespectively, and the levels of CRP of Ⅰ group and Ⅱ group were obviously higher than those of Ⅲ group and Ⅳ group(P< 0.05 ), but there was no significant difference either between Ⅰ group and Ⅱ group,or between group and Ⅳ group. Maintenance rate of sinus rhythm of the four groups was 57.9%,79.4%,77.1%,85.3% respectively,the maintenance rate of sinus rhythm of Ⅰ group was significantly lower than that of Ⅱ,Ⅲ and Ⅳ group (P<0.05). Conclusions Va]asrtan and pravastatin may reduce recurrence of paroxysmal atrial fibri]lation in patients with chronic congestive heart failure. Valsartan may inhibit dilatation of left atrium, and pravastatin may decrease the level of CRP in blood.

Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.

Objective To explore the relationship of plasma level of B-type natriuretic peptide (BNP) with cardiovascular risk,the severity of coronary heart disease(CHD),and the short-term prognosis in patients with type 2 diabetes. Methods 154 patients with type 2 diabetes,of them 95 cases complicated with CHD and 65 with hyper-tension were selected in this study. The CHD patients were diveded into 3 groups: AMI(n=32), UAP(n=33) and SAP(n=30). The relationship of the plasma BNP levels with cardiovascular risks, with each coronary heart disea-ses,were observed. The patients were followed up for 6 months to study the predicting role of BNP on the death in pa-tients accompanied with CHD. Results The plasma BNP level was (397.34±217.79) ng/L, which was correlated with age, CRP, hypertension and CHD (r=0.631,0.672, 0.762,0.857, P<0.05 for each);the plasma BNP levels increased with age(r=0.896,P<0.01):(57.6±12.3) ng/L in patients <50 years old,(146.2±53.4)ng/L in patients 50≤and < 59 years old, (388.4±67.5) ng/in patients 60≤and < 69 years old, and (423.8±132.6) ng/L in patients≥70 years old (P<0.01 or P<0.05). The plasma BNP levels, was higher in patients with hyper-tension than that in patients without hypertension [(314.7±125.3) ng/L vs (136.8±98.7) ng/L, P<0.01];Higher in patients with CHD than that in patients without CHD [(425.03±200.80)ng/L vs (37.64±21.57) ng/L,P<0.01)]. The short-term prognosis of patients with CHD was correlated with the levels of BNP, and BNP levels≥485 ng/L may be an independent predicting factor for cardiac death within one month. Conclusions Plas-ma levels of BNP were associated with some cardiovascular risks,which may be one of biomarkers for cardiovascular risks in patient complicated with CHD.

Objective To study the efficacy and safety of ibutilide for AF and atrial flutter.Methods Thirty-two AF and atrial flutter patients with arrhythmia ≤3 months were randomly divided into ibutilide treatment group (n=17) and amiodarone treatment group (n=15).The patients in ibutilide treatment group were treated with 10 ml 5％ glucose injection containing 1 mg ibutilide,which was repeated after 10 min if it was ineffective and those in amiodarone treatment group were treated with 10 ml 5％ glucose injection containing 150 mg amiodarone,which was repeated after 10 min if it was ineffective.Results The total recovery rate of AF and atrial flutter was significantly higher in ibutilide treatment group than in amiodarone treatment group (64.7％ vs 40.0％,P＜0.05).The mean recovery time of AF and atrial flutter was significantly shorter in ibutilide treatment group than in amiodarone treatment group (29.28±12.57 min vs 70.59±16.83 min,P＜0.01).Conclusion Ibutilide can rapidly recover AF and atrial flutter with a high success rate and a reliable safety.The therapeutic effect of ibutilide is better than that of amiodarone for AF and atrial flutter.